On 24 November 2024, Decision No. 1642 of 2024 of the Minister of Youth and Sports was issued, concerning the adoption of the regulations on the controls and procedures of health and medical care for youth and sports bodies and facilities, which obliged bodies to apply a unified medical code for medical examinations and to ensure the provision of first-aid and medical equipment at facilities and activities, with the aim of protecting athletes’ health and reducing the risk of sudden deaths.
However, the implementation of the decision, which came into force on 3 January 2025, saw widespread problems over the past year, as a result of confused instructions from clubs and sports federations regarding the procedures for obtaining sports medical codes for players of different age groups and classifications, and the places where they could be obtained, which burdened players and their families with additional burdens and economic costs.
Following the decision, clubs’ implementation of the decision on obtaining the “medical code” was limited to carrying out the required medical examinations at Armed Forces and Police hospitals, on the pretext of obtaining the “eagle stamp”, and the cost of the examinations reached EGP 2,000 and exceeded it in some places, which pushed parents to search for weeks for cheaper alternatives, as Samah Sayed, the mother of a swimmer at a Cairo club, recounts.
During her search, she went to the Islamic Center for Cardiac Diseases at Al-Azhar University’s Faculty of Medicine for Boys, which performed an electrocardiogram, an echocardiogram, a pulmonary function test and a complete blood count for her son, to obtain his sports medical code and register him with the Swimming Federation, for EGP 800.
She criticises the obligation on all players, including children in the early stages of learning, to obtain the medical code, explaining that she has seen children aged between five and seven undergoing the same procedure, considering that the decision has imposed a heavy financial burden on families, especially those with more than one child practising sport, and stressing that the high costs have pushed some families to stop their children from swimming or from sports activities.
She tells Zawia3: “The medical code has in many cases turned into a formality; the papers are not reviewed or actually made use of, as evidenced by the continued occurrence of cases of suffocation, fainting and health crises among players during competitions and training, and it seems that their purpose is limited to absolving the federation or the club of responsibility.”
She adds that the Swimming Federation later amended the fees according to the different categories after objections from parents, but implementation remained uneven between clubs, as some adhered to the new classifications, while other clubs continued to oblige all players to follow the same procedures.
She points out that some clubs tried to provide medical convoys at their premises, while many parents resorted to looking for cheaper hospitals, some of which carry out all the required examinations accurately, while others merely issue the papers without completing all the items of the medical examination, as she puts it.
Last year, the search for a cheaper alternative for obtaining the medical code led Rabab Hassan, the mother of a karate player in Alexandria, to have his medical examinations done at Abu Qir General Hospital for EGP 280, as it was the cheapest option for her, but she was confronted with the hospital’s lack of cleanliness, and with some staff demanding that those wishing to undergo the examinations pay sums of money to ease their entry ahead of their turn.
Despite the ordeal she went through to get her son to the examination room, she found that the medical examination itself was a formality and did not reach the required standard, adding to Zawia3: “The alternative was to do the examinations at Armed Forces or Police hospitals, but their cost reached about EGP 1,400, which represented a financial burden for most parents.”
Amid parents’ complaints about the financial and organisational burdens associated with obtaining the medical code, Rabab points out that in the 2026-2027 sports year the Ministry of Youth and Sports has provided a medical examination service for athletes inside the Youth City in Abu Qir for EGP 500, and has assigned an official in Alexandria Governorate to coordinate with clubs, youth centres and academies and to gather players to undergo the examinations in the presence of doctors, something that had not been available before.
With the start of 2026, the Central Administration for Sports Medicine announced that Thursday of every week would be allocated for carrying out the medical code for those wishing to do so, with the medical examination to be conducted at the sports medicine unit of the Olympic Centre in Maadi, applicants being required to bring a recent personal photograph of each player and a copy of the birth certificate, and the fees to be paid by Visa card.
In this regard, Heba Mohamed, a women’s boxing coach in Assiut Governorate, explains that applying the medical code requirements imposes heavy financial and logistical burdens on players and coaches in the governorates, explaining that she has to take more than 20 players to Cairo for the medical examinations, which adds high travel costs, in addition to medical examination fees that reach about EGP 1,500 per player.
She notes that the burdens do not stop at obtaining the medical code, as the team must return to Assiut and then collect new sums to cover the costs of travel, accommodation and participation in the championship in Cairo, along with the costs of food and drink throughout the competitions and the registration fees, considering that these costs represent a burden beyond the means of many families.
She says: “Assiut Governorate has a sports medicine unit, but it does not provide all the required examinations, as its work is limited to the internal medicine examination and the electrocardiogram, which forces players to travel to Cairo to complete the rest of the procedures.”
She believes that completing the equipping of the sports medicine units in the governorates and providing all the required examinations there would be more effective in easing the burdens on athletes and coaches than obliging them to travel to the capital, considering that the continuation of the current situation makes practising sport more difficult for people from the governorates, and limits the ability of many players to continue competing because of the high costs.
Financial and Procedural Burdens
Following a wave of complaints on social media throughout 2025, the then Minister of Youth and Sports, Dr Ashraf Sobhy, who left his post weeks later in a cabinet reshuffle in which he was succeeded by Gohar Nabil, announced on 17 January 2026 a reduction in the financial costs of the medical examination and medical code procedures for athletes at the ministry’s sports medicine units in the various governorates, as well as at the medical convoys.
The following day, on 18 January 2026, the Ministry of Youth and Sports issued Decision No. (109) of 2026, which included amendments to the regulations on medical and health requirements. Article One obliged all youth and sports bodies and facilities, companies operating in the field of sports services and investment, factory company clubs, ministry clubs and specialised federations to work to protect athletes’ health and reduce the risk of sudden deaths during training, competitions or general practice, to put in place precautionary and preventive measures, to carry out comprehensive periodic medical examinations and assessments of cases, and to put in place effective proactive plans for sudden health cases. Article Two provided for obliging those institutions and bodies to apply the unified medical code for medical examinations to competitive activities and sports, according to four levels determined on the basis of the level of sports participation.
The unified medical code was divided into four levels: the first is for general practice, and covers sports activities within bodies that do not fall within high-performance competitions, without requiring prior examinations, with adherence to general safety procedures and an obligation on bodies to provide medical equipment, including a medical clinic equipped with all requirements, among them cardiac resuscitation devices and other first-aid supplies. The second is for academies and training centres, at a cost ranging from EGP 200 to 250, and includes the medical history of the player and the family, a clinical examination, internal medicine examinations, an electrocardiogram and a complete blood count.
The third level is for national championships and federations, at a cost ranging from EGP 400 to 500, and includes all the second-level examinations in addition to an ultrasound of the heart (echo). The fourth level is for national team players, and includes all the third-level examinations, in addition to an exercise stress ECG to ensure full health readiness during training and competitions. The tests and the medical examination are valid for a full year, and the medical examination is also valid for a player who practises more than one sport, in accordance with the approved controls.
Nevertheless, complaints from professional and amateur players and from the parents of children enrolled in academies and sports clubs continue, on social media and at sports facilities, months after the decision was issued, because of the arbitrariness of some clubs in the procedures for obtaining the code, obliging them to have it done at particular hospitals or with specific companies or medical convoys at higher prices, which burdens them financially and procedurally, especially as these do not adhere to the prices of the four levels set by the decision.
Mohamed Mansour, the father of three children who practise swimming and karate at a private-sector company club in Cairo, complains that the cost of the medical examinations reaches about EGP 2,000 in some cases, with clubs obliging parents to have them done at specific bodies such as Police and Armed Forces hospitals, at higher prices, even though they are available at public hospitals at lower prices.
Drawing on his experience last June, he explains that a child joining any sports activity now requires completing a large number of procedures, including undergoing multiple medical examinations, such as an electrocardiogram, tests and a clinical examination, and submitting additional documents, among them a computerised birth certificate and a declaration from the parent assuming responsibility for the child’s practice of sport, which he considered an administrative and financial burden on families, criticising what he described as some medical bodies merely completing the paperwork and carrying out limited examinations without applying all the required items of the examination, which deprives the medical code of its real purpose.
He questions the justification for requiring medical examinations to be repeated when a player moves between clubs, and for requesting documents that have already been submitted, as well as for restricting some examinations to specific bodies, considering that the procedures followed for obtaining the medical code complicate the practice of sport and impose unjustified burdens on athletes and their families, instead of addressing negligence and weak safety procedures.
As for Ahmed Ayoub, a football coach for juniors at a private sports academy in Cairo, he believes that the mechanism for applying the medical code in its current form needs review, given the differing examination fees at the accredited bodies, which range, according to him, between about EGP 850 and 1,500, imposing varying financial burdens on parents in the absence of unified and clear standards.
He says: “Parents face conflicting instructions from the bodies that carry out the examinations, as some hospitals require the child to fast before some tests, while other bodies do not require this, which raises questions about the standardisation of the procedures for applying the medical code,” noting that he had the medical examinations done for his son, but did not see a unified or comprehensive application of the procedures, in addition to differences in prices and implementation mechanisms between hospitals.
He stresses that the priority should be improving the medical care system inside stadiums and sports facilities, and providing accredited medical convoys inside clubs for specific periods, which would allow athletes to be examined at their training venues and ease the burdens on families, warning that the high cost of obtaining the medical code is pushing some families to keep their children away from sport, which affects the discovery of sporting talent and its continuity.
He proposes launching a joint initiative between the Ministries of Youth and Sports and of Health to carry out medical examinations for athletes for symbolic fees or free of charge, along the lines of the national health initiatives, as well as making use of the sports medicine units, company-affiliated clubs, contributions from businesspeople and the free treatment departments of private hospitals, together with issuing unified controls for applying medical examination procedures, ensuring fairness and equal opportunities among all athletes.
Double Burdens for Paralympic Players
There are 18 sports medicine units in Egypt distributed across a number of governorates, which the Ministry of Youth and Sports announced in January 2026, including the Olympic Centre in Maadi in Cairo, the Kafr El-Sheikh unit in a separate building inside the stadium, the Dakahlia unit beneath the stands of Mansoura Sports Stadium, the Menoufia unit in a separate building inside Shebin Stadium, as well as the Sharqia unit beneath the swimming pool at Zagazig Stadium, the Ismailia unit in the Sheikh Zayed area at the international swimming pool, the North Sinai unit in El-Arish in the Al-Dahiya area inside El-Arish Stadium, and the Qalyubia unit beneath the Directorate of Youth and Sports.
Meanwhile, the Aswan unit is located on Corniche El-Nil Street inside the swimming pool of the Directorate of Youth and Sports, the Fayoum unit inside Fayoum Stadium, the Alexandria unit inside the Youth City in Abu Qir, the Beheira unit next to the Directorate of Youth and Sports, as well as the Port Said unit at the Sports City, the Assiut unit at Al-Arbaeen Stadium, the Qena unit at the covered hall, the New Valley unit opposite the Youth City in Kharga, the Suez unit next to the Directorate of Youth and Sports, and the Beni Suef unit inside the sports stadium.
However, the greater part of the ordeal of obtaining the sports medical code is borne by Paralympic athletes; Abdel Rahman Mohamed, a Paralympic swimmer with a motor disability who lives in Alexandria Governorate, reveals that the requirement to carry out the medical examinations at specific places, mostly at the Olympic Centre in Cairo, imposes additional burdens on them and their families, especially those coming from the governorates, calling for the service to be provided within each governorate through the Directorates of Youth and Sports or health insurance, or through accredited medical convoys, to spare them the hardship and costs of travel.
At a time when athletes with disabilities need more support and facilitation, the player complains that they are made to bear the cost of travel and accommodation as well as the medical examination fees, which represents a burden that many families find hard to bear, especially as the required examinations are repeated every sports season and for more than one player within the same family.
He believes that addressing the causes of accidents in championships should focus on improving organisation and providing equipped ambulances and integrated medical teams at competitions, instead of burdening parents with additional financial costs that do not, in his view, address the causes of those accidents.
He warns that the high cost of the procedures may deprive many financially disadvantaged players of completing their sporting careers, despite their talent, which threatens the principle of equal opportunity, calling for a review of the mechanisms for applying the medical code and for the economic circumstances of families to be taken into account, and proposing the organisation of days dedicated to examinations within each governorate instead of obliging players to travel to Cairo, which would ease the financial burdens and keep athletes practising their sports.
Paralympic tennis player Sameh Eid, for his part, stresses to Zawia3 that the application of the sports medical code and the examinations needed to obtain it have increased the burdens borne by players in general and by Paralympic players in particular, as those among them with motor disabilities face great difficulty in moving from one area to another and from the governorates to Cairo, where the Olympic Centre in Maadi is located, especially as the sports medicine units announced by the ministry are available in only 16 governorates, as he puts it.
He explains that the material burdens of obtaining the sports medical code are doubled for Paralympic players, who receive no pay before winning an Olympic medal, and who bear at their own expense the costs of their travel and the burdens of training and taking part in championships; he explains that the cost of travel and accommodation for a sports team comes to EGP 30,000 to 40,000, at a time when a Paralympic club’s budget may not exceed EGP 100,000.
Hospitals Not Bound by These Regulations
The sports medical code represents a unified system of medical examinations carried out on athletes before they take part in competitions, with the aim of assessing their health condition, especially the health of the heart, and creating a documented medical database that helps detect diseases early and reduce the health risks associated with practising sport, as explained by Professor Ahmed Ashraf Eissa, consultant in cardiology, interventional catheterisation and sports cardiology at the Academy of Cardiac Surgery at Ain Shams University, and president of the Egyptian African Society for Cardiac Research and Diseases.
He explains that the basic examinations include reviewing the player’s medical history, a clinical examination, an electrocardiogram and an echocardiogram, as well as some medical tests, while other examinations such as an exercise stress ECG, respiratory capacity measurement, chest X-rays and others are added according to the nature of the sport and the requirements of continental and international federations, stressing that all athletes undergo the minimum of basic examinations, and the additional examinations then differ according to the type of sport and the level of competition.
He tells Zawia3: “The application of the sports medical code came in response to two main reasons; the first is keeping pace with international standards, which now require an integrated system for screening athletes, and the second is reducing the health incidents that Egyptian stadiums have witnessed in recent years. Sports cardiac screening is no longer an optional procedure, but has become an essential part of developing the sports system and protecting players.”
Nevertheless, he stresses that medical examinations do not prevent all deaths on the pitch, but they increase the chances of detecting serious diseases before taking part in competitions, as early detection makes it possible to suspend a player who has a health problem until treatment, or to ban him permanently from practising sport if his condition poses a danger to his life; and although the examinations are theoretically capable of detecting the vast majority of medical conditions, they cannot predict all the emergency factors a player may be exposed to during competitions, such as psychological pressure, severe exhaustion or newly arising health conditions.
He reveals that most causes of sudden death among athletes under the age of 35 are linked to cardiac electrical disorders or some congenital diseases, while coronary artery diseases increase as a main cause after this age, pointing out that some diseases, such as the presence of an extra electrical pathway in the heart, can be treated and the player then allowed to return to competition, whereas other diseases, such as hypertrophic obstructive cardiomyopathy, require a permanent ban from practising sport to preserve the player’s life, with members of his family undergoing genetic testing because the disease is hereditary; the suspension decision is issued after review by the competent medical committee, and the report is then submitted to the club and the sports federation to take the necessary measures.
He believes it is still too early to draw precise indicators regarding the rates of heart disease among athletes in Egypt, explaining that the application of the medical code is still recent, and that assessing its results requires the accumulation of data and statistics over several years, noting that he has personally examined more than 5,000 professional athletes, the vast majority of whom did not suffer from diseases requiring suspension from practising sport, while the cases that required a ban or treatment were limited to a small percentage.
Asked about the material costs of obtaining the medical code, he points out that the Ministry of Youth and Sports has set guideline regulations for the prices of examinations at accredited bodies and companies, with the aim of easing the financial burdens on athletes, but hospitals are not bound by these regulations, and may provide the service at higher prices depending on their operating costs, as the ministry cannot oblige all private hospitals to adopt a unified price.
Eissa rejects what is being said about the possibility of obtaining medical fitness certificates without undergoing the examinations, describing these claims as “devoid of truth”, and stressing that the discussion of parents’ complaints regarding the costs of the examinations, the mechanisms for applying the medical code and the choice of accredited bodies falls within the remit of the Supreme Medical Committee at the Ministry of Youth and Sports.
Arrangements Specific to Clubs
In the same context, Dr Hazem Khamis, head of the Supreme Medical Committee at the Ministry of Youth and Sports, stresses that the committee is responsible for setting the controls of the sports medical code and determining the required examinations and their pricing within the sports medicine centres affiliated with the ministry and the companies contracted with it, considering that what happens in some clubs, where parents are obliged to have the examinations done through particular convoys or bodies, does not fall within the ministry’s remit, but rather constitutes arrangements specific to the clubs.
He explains that the ministry’s sports medicine centres in the governorates are committed to applying the medical code regulations and the approved prices, noting that the fees set at the bodies contracted with the ministry range between EGP 500 and 750 depending on the category, while the prices of hospitals or bodies not subject to the ministry’s supervision vary according to their policies, and the ministry does not have the authority to oblige them to charge specific prices.
He tells Zawia3: “Clubs do not have the power, under the regulations, to oblige players to undergo the examinations at a particular hospital or medical convoy, as long as the player submits a complete medical examination certificate issued by an accredited government body and bearing the required official stamps, and refusing such certificates may expose the club to accountability.”
He explains that the government bodies permitted to carry out medical examinations include public hospitals, university hospitals and Armed Forces and Police hospitals, as well as the hospitals of public authorities that provide the service, along with private companies contracted with the Ministry of Youth and Sports to obtain the necessary accreditation; however, some clubs, according to him, conclude direct agreements with these companies to organise medical convoys at their premises at higher prices, which is a matter separate from the regulations set by the ministry.
Regarding demands for the examinations to be carried out through health insurance, he explains that all children in Egypt up to the age of 18 enjoy health insurance at the state’s expense, but including the medical code examinations within the universal health insurance system requires a study of the health system’s capacity to absorb this volume of services, especially with the gradual expansion of the application of universal health insurance in the governorates.
He points out that the Supreme Medical Committee continues to develop the medical code system and to regulate its procedures, stressing that the main aim of applying it is to preserve athletes’ health and to unify the standards of medical examination before taking part in sports activities, while some of the practices parents complain about remain linked to the implementation mechanisms of clubs or of bodies not subject to the ministry’s direct supervision.
Although the sports medical code represents a necessary step to protect players and reduce sudden deaths on the pitch, its success remains dependent on a unified and fair application that balances safety requirements with athletes’ ability to bear the cost.
While officials stress that the regulations of the Ministry of Youth and Sports do not oblige players to use particular bodies, the testimonies of players and parents reveal continued uneven application and the imposition of financial and procedural burdens that may prevent the practice of sport, which makes it necessary to complete the equipping of the sports medicine units in the governorates, to tighten oversight of clubs, and to ensure that examinations are available at unified prices within reach of all athletes.
